Bariatric Surgery Lowers Cancer Risk for Severely Obese Patients

Dr. Sukhvinder Singh, Saggu, Department of Obesity & Metabolic Surgery, Apollo Spectra HospitalsDr. Sukhvinder Singh Saggu is a General Surgeon and Laparoscopic Surgeon in Karol Bagh, Delhi with an experience of 15 years in these fields.

The popularity of obesity has increased and is now one of the leading public health concerns on a worldwide scale. Obesity is a chronic progressive disease with an excessive accumulation of body fat that might affect your health and can reduce life expectancy. Obesity is a major risk factor in the development of metabolic syndrome, elevated blood pressure, elevated blood cholesterol, and lipids, leading to heart disease and stroke.

Bariatric surgery makes changes to the digestive system by restricting how much you eat in one sitting or how nutrients are absorbed by the body. It is a major procedure that is usually permanent and it requires long term adjustments to your diet and lifestyle. It also carries an inherent risk and is generally recommended only when obese patients fail to lose weight by conservative measures, such as diet and exercise.

Is Obesity to Blame for the Rising Concern of Cancer?
Excess of body fatness is already recognized as an important cause of cancer and has been estimated to account for six percent of all cancers in developing countries. More than two out of three adults are considered overweight and one out of three adults is clinically obese in India.

The prevalence of overweight and obesity is increasing worldwide and due to this the link between obesity and cancer is growing. Obesity rates have been rising across age groups for years and according to some recent data, almost 36 percent of adults ages 20-39 are obese, and that number may soon be even higher. Though cancer has always been hit hard to older adults but nowadays easily found in younger age groups as well. Genetic lifestyle and health factors can be the reason for some of cancer like smoking for lung cancer or HPV for cervical cancer. Obesity is among the most impactful of these. Research has linked excess body weight to about 40 percent of cancer cases and it's a common risk factor breast, ovarian and liver cancer.

Excess weight may promote cancer in several ways. It can increase inflammation which can easily be a risk factor for a number of chronic conditions and has been found to fuel cancer cell growth. It may also alter levels of sex and growth hormones, as well as insulin, which can spark growth factors that allow cancer cells to proliferate. And some fattening foods, such as processed meats and snacks have been independently linked to cancer risk.

The future burden of these cancers might get worsen in young age peoplewho share simila characteristics, potentially halting or reversing the progress achieved in reducing cancer mortality over the past several decades.

The prevalence of overweight and obesity is increasing worldwide and due to this the link between obesity and cancer is growing

Is Bariatric Surgery a Solution?
Bariatric surgery is currently the most efficient and enduring treatment for clinically severe obesity. Patients who have had bariatric surgery for weight loss reduces the cancer incidence and mortality.

Bariatric surgery is currently the most productive long term treatment for weight loss and an improvement in the diseases related to obesity. Although this surgery has become increasingly safe with advancements in laparoscopic and endoscopic technologies, it remains an invasive and life altering procedure with many possible short & long term complications. Several mechanisms for the effectiveness of bariatric surgery have been figured out, and these may provide useful pharmacological targets to narrow the gap between medical and surgical management of obesity in the future.

Adults who had a BMI of 50 or higher at the time of bariatric surgery had a 40 percent higher risk of incident cancer vs those with a baseline BMI under 40. Total weight loss wasn't the only outcome from bariatric surgery but decreases in some metabolic parameters after surgery were also tied to a reduced incident cancer risk. Patients with severe obesity, weight loss after bariatric surgery was associated with a lower risk of incident cancer and there was no apparent effect of bariatric surgery on cancer risk that was independent of weight loss.

Does the Surgery Lead to Side Effects?
People are having a wrong idea, if they feel that bariatric surgery holds any side effects. It has purely a safe procedure. There are certainly some inherent risks as with all major surgery and complications include, but curable:-
•Excessive bleeding
•Adverse reactions to anaesthesia
•Blood clots and deep vein thrombosis
•Lung or breathing problems
•Intestinal leaks in staple line or joints

In the longterm, you may not lose the weight you hoped for and the weight may return again. This usually happens if a patient does not stick to doctor's recommendations or fails to make the required lifestyle changes including adopting a healthy eating habit and regular exercise regime. Surgery alone is not the answer. One will need to be prepared to make lifelong lifestyle changes to benefit from bariatric surgery.

Speak to your surgeon and have all your questions answered before you decide if bariatric surgery is right for you.